Physicians' Academy for Cardiovascular Education

Evidence suggests proton-pump inhibitor can lower risk of severe GI bleeding in the elderly on antiplatelet therapy

Age-specific risks, severity, time course, and outcome of bleeding on long-term antiplatelet treatment after vascular events: a population-based cohort study

Literature - Li L, Geraghty OC, Mehta Z, et al. - Lancet 2017; published online ahead of print

Main results

Conclusion

In patients on secondary prevention for ischemic events, receiving antiplatelet therapy without routine PPI use, the long-term risk of bleeding at age 75 years or older is higher and more sustained compared with younger age groups, with particularly high risks of disabling or fatal upper GI bleeding. The estimated NNT for routine PPI use to prevent major upper GI bleed is low and co-prescription should be considered in future secondary prevention guidelines.

References

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Find this article online at The Lancet

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